Trombólisis sistémica precoz en el infarto agudo del miocardio: resultados clínicos y angiográficos / Systemic early thrombolysis during myocardial infarction: clinical and angiographic results

RESUMO

Systemic thrombolysis is an effective therapy for acute myocardial infarction, since it restores coronary flow and contributes to preserve left ventricular function. We analyzeour experience with intravenous thrombolytic therapy in 45 cases with acute myocardialinfarction treated within 6 hours of onset of symptoms. 28 patients had anterior and 17 inferior myocardial infarction. We treated 38 patients with streptokinase 1 to 1,5 million units infused during a during a 30 to 60 minute period and 7 patients with tissue plasminogen activator factor, 100 mg infused during 2 hours. Regression of chest pain and ST segment elevation and early CPK peaking (< 4 hours) were utilized as criteria for reperfusion. Accordingly 20 patients (64%) met these criteria. Coronary angiogram ws performed within 7 days in 38 patients. It disclosed a patent coronary artery in the infarcted area in 28 cases (74%). Transient hypotension with thrombolytic therapy was observed in 17 patients (38%) and bleeding complications in 3 cases (7%). Two patients (4%) died early after therapeutic failure. In summary we have confirmed that intravenous thrombolytic therapy is safe and effective in the early period of myocardial infarction and that is associated with a high incidence of clinical and angiographic reperfusion